Osteoporosis risk assessment of mature working women: primary and secondary prevention strategies.

1. Occupational health nurses have a prime opportunity to promote a healthy and stable population of working women through teaching osteoporosis risk reduction behaviors and conducting periodic osteoporosis risk assessments. 2. Health teaching about osteoporosis prevention is needed to foster health promotion and risk reduction behaviors among pre-, peri-, and postmenopausal women to lessen the incidence of fractures and secondary consequences. 3. By incorporating primary and secondary prevention strategies into occupational health nursing practice, great strides can be made in guiding women to initiate osteoporosis prevention behaviors to promote a more healthy and less restrictive lifestyle in later years.     

Health promoting behaviors among African American women with faith-based support.

The purpose of this qualitative exploratory study was to document health perceptions, beliefs and attitudes, intentions and social pressures that influence health promoting behaviors as expressed by community level aggregates of African American women with faith support. Twenty-six African American women from two large urban congregations with an active health ministry program participated in this study. Focus group interviews guided by the Theory of Planned Behavior (Ajzen & Fishbein, 1980 & 1991) were used to identify salient health perceptions, beliefs and attitudes, intentions, and social pressures influencing health-promoting behaviors in African American women with faith-based support. Positive health perceptions, attitudes, and beliefs were identified as important to engaging in a healthy lifestyle. Exercise, well balanced diets, weight reduction and stress management were the most salient health concerns among the respondents. Key referents identified included the pastor, congregational nurses, physicians, and church/family members. Control beliefs among these women reflected salient spiritual and fatalistic beliefs concerning health-promoting behaviors. Trusting relationships, open communication, safe, comfortable, and familiar environments were identified as important considerations when planning health promotion interventions for an African American faith community. CONCLUSIONS: Health beliefs, attitudes, and behaviors are not developed outside of social systems, therefore, the facilitation of healthy lifestyle behaviors may be best assessed and influenced within a context of reciprocal social interaction such as in a faith-based community. In the context of a community level aggregate with faith-based support, behaviors to promote a healthy lifestyle may be positively influenced.     

Hip Hop,Health, and Human Papilloma Virus (HPV): Using Wireless Technology to Increase HPV Vaccination Uptake

National incidence rates of cervical cancer are disproportionately higher in African-American women, and cancers related to human papillomavirus (HPV) infection impose an enormous health burden of over $3.7 billion annually. Current efforts to use Hip Hop culture to address health disparities include disease prevention and health promotion. The use of Hip Hop cultural cues for HPV vaccination uptake and education was developed through an interdisciplinary collaboration. Interventions that incorporate youth values and beliefs are needed to reduce an escalating HPV infection trajectory. Prior research has shown that Hip Hop music has a significant influence on the sexual attitudes and behaviors of African-American emerging young women, providing a context within which to prevent risky behaviors. The current study examines the efficacy of a Hip Hop-based HPV vaccination uptake feasibility project that integrates wireless technology among African-American female college students. Findings suggest that cultural relevance of Hip Hop to the lives of young African-American women increases the acceptability of transmitted health messages. Discussion is centered on implications of wireless technology and Hip Hop as a viable approach to increase HPV vaccination, and a formal randomized control trial is planned.     

Osteoporosis education programs: changing knowledge and behaviors

Osteoporosis is an age related metabolic disease that primarily affects women and causes bone demineralization that results in fractures. Early identification of risk factors for osteoporosis and development of prevention programs is needed to halt the increasing incidence of the disease. Public health nurses (PHNs), with their emphasis on primary, secondary, and tertiary prevention with individuals and families, are in a unique position to protect the health of these vulnerable populations who are at risk for osteoporosis. This article describes the implementation and program evaluation of three osteoporosis prevention educational programs that use three levels of intensity of design. Each design is based upon the learning needs of the targeted audience. The goals of each program were to increase knowledge of osteoporosis, increase health beliefs, and increase the frequency of osteoporosis preventing behaviors. Theoretical aspects from adult learning and the Health Belief Model (HBM) were used to develop the programs. For the program evaluation, participants completed evaluation instruments before and 3 weeks after participating in an osteoporosis health education program. Participants in all programs had significantly higher levels of knowledge after completing the programs; however, overall, there was no change in health beliefs or behaviors. Implications of these findings are discussed.     

Symptoms,aging-stereotyped beliefs,and health-promoting behaviors of older women with and without osteoarthritis

The purposes of this study were to examine differences in symptoms, aging-stereotyped beliefs about management of symptoms, and health-promoting behaviors depending on a diagnosis of osteoarthritis and to investigate the associations between symptoms, aging-stereotyped beliefs, and health-promoting behaviors in 171 older Korean women. Compared to older women without osteoarthritis, those with osteoarthritis reported significantly more symptoms, a higher level of aging-stereotyped beliefs, and a lower level of health-promoting behaviors. Regardless of osteoarthritis, older women suffered from multiple symptoms, and musculoskeletal symptoms were the most frequently reported symptoms. Aging-stereotyped beliefs had a negative influence on health-promoting behaviors, whether or not older women were diagnosed with osteoarthritis. Findings of this study suggest that a broader assessment of multiple symptoms, specifically including musculoskeletal symptoms, is needed in order to enhance their management of symptoms. Health care providers should consider age stereotypes with regard to experience and management of symptoms in order to improve self-care behaviors of older people, and development of nursing intervention strategies in order to modify stereotypes and misconceptions about aging and to facilitate positive attitudes about old age is warranted.     

Comparison between African-American and white women in their beliefs about breast cancer and their health locus of control

The purpose of this study was to examine the health beliefs of African-American and white women about breast cancer and locus of control, using the health belief model and the health locus of control construct. The Health Screening Questionnaire, developed by Sugarek, Deyo, and Holmes, was used to collect self-report data about health beliefs related to breast cancer and health locus of control. Participants included 197 white and 152 African-American women, between the ages of 19 and 93, recruited from various settings in central Florida. Significant differences were found between the two groups on all of the health beliefs about cancer items. The African-American women were significantly more likely to believe in chance, or to depend on powerful others for their health. Perceived susceptibility to cancer, doubts about the value of early diagnosis, and beliefs about the seriousness of breast cancer all were significantly associated with powerful other scores among African-American women. There was no relation between health beliefs and years of education for African-American women, but for white women, those with the least education were more likely to believe that death was inevitable with a cancer diagnosis. These results add to the information needed for the development of effective programs aimed at increasing breast cancer screening among African-American women.     

Factors influencing osteoporosis knowledge: a community study

According to the 2004 Surgeon General's report, more than 10 million people in the United States have osteoporosis, and another 34 million are at risk of developing this crippling disease that affects the quality of life. Efforts must be made to stem this disease that may be largely prevented with lifestyle changes. To engage in self-care to prevent osteoporosis, people need to have knowledge of risks and preventive behaviors. The purpose of this study was to examine factors influencing osteoporosis knowledge in 255 people in a university community. The Facts on Osteoporosis Quiz (Ailinger, Lasus, & Braun, 2003) was used to measure osteoporosis knowledge. Findings indicated that respondents had inadequate knowledge about osteoporosis. Age was positively correlated with knowledge (r = .27, p < .000), but education was not. There were marked differences in mean scores among ethnic groups. The findings suggest topics that community health nurses need to focus on in their osteoporosis educational interventions.     

Gestational diabetes: prospective interview‐study of the developing beliefs about health,illness and health care in migrant women

Aims and objectives. To explore the development over time of beliefs about health, illness and health care in migrant women with gestational diabetes mellitus born in the Middle East and living in Sweden and to study the influence on self‐care and care seeking. Background. With today’s extensive global migration, contact with the new society/health care confronts the migrant’s culture of origin with the culture of the host country. The question is whether immigrants’ patterns of beliefs about health, illness and health‐related behaviour change over time, as no previous studies have been found on this topic. Design. A qualitative prospective exploratory study. Methods. Semi‐structured interviews, with 14 women (28–44 years), on three occasions: during pregnancy in gestational weeks 34–38 and three and 14 months after delivery. Results. There was a U‐shaped development of beliefs, from focusing on worries about the baby’s health during pregnancy and trying to comply with advice from health professionals, particularly a healthy diet, through regression to dietary habits (more sugar, less fibre) and lifestyle held before being diagnosed with gestational diabetes mellitus three months after delivery, back to a healthy diet/lifestyle and worries 14 months after delivery but then focusing on their own risk, as mothers, of developing type 2 diabetes and being unable to care for the child. Over time, the number of persons perceiving gestational diabetes mellitus as a transient condition decreased. Respondents lacked information about gestational diabetes mellitus, diet and follow‐ups. Conclusion. Beliefs changed over time and influenced health‐related behaviour. Beliefs about the seriousness of gestational diabetes mellitus among healthcare staff/care organisation influence the development of patients’ beliefs and need to be considered in planning care. Relevance to clinical practice. Pregnancy should be used as an opportunity to provide complete information about gestational diabetes mellitus and future health risks. This should continue after delivery and wishes for regular follow‐ups should be met.     

Employee counseling with respect to lifestyles, life events, and breast cancer risks

1. All women should be considered at risk for breast cancer, because about 75% of the cases occur in women who are not considered high risk, or in whom no cause is identified. 2. Risk is a function of unalterable genetic and constitutional factors that are modified by lifestyle, life events, and environmental factors. 3. Knowledge about factors that influence employee behaviors regarding their risks is useful for planning strategies to encourage health-promoting behaviors. 4. The future goal of education and counseling will be primary prevention as well as early detection of breast cancer.     

Explore the effectors of bone mineral density in community women

Epidemiological studies that involve Asian women have revealed that their bone mineral density (BMD) is lower than that of European and American women. Few studies have simultaneously investigated the cognition, beliefs and behavior that affect BMD. The first aim of this study was to elucidate the relationships between demographics, knowledge of osteoporosis, health beliefs about osteoporosis, health-related behavior and BMD. The secondary goal was to explore the major predictive factors that affect the BMD of women in Community. This was an exploratory, community-based, cross-sectional study. Participants (N = 98) completed the osteoporosis related questionnaire and were invited to undergo BMD examinations using quantitative ultrasound (QUS). Overall, 73.4% of the participants had heard of the disease but the proportion of correct responses to the questions that tested knowledge of osteoporosis was only 44.0%. The investigation into osteoporosis-related beliefs revealed that women held quite accurate beliefs regarding the prevention of osteoporosis, but only 23.6% of them had undergone a BMD examination. An adjusted odds ratio indicated that if women had normal BMD then they were 1.57 times (95% CI: 1.08-2.29), 1.10 times (95% CI: 1.00-1.12) and 2.74 (95% CI: 1.09-6.86) times than their counterparts, respectively. The results revealed that women with normal BMD were more likely to have positively self-rated health, knowledge of osteoporosis and preventive behavior than their counterparts. The findings indicated that BMD was subjectively determined by a combination of cognitive and behavioral factors. Early detection was the key to preventing osteoporosis.     

One theoretical framework for cardiovascular disease prevention in women

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for women in the United States. Vulnerable and underserved women are even less likely to participate in healthy lifestyle behaviors to prevent CVD than the general US population. Many women are not aware that they are at risk for CVD and do not modify unhealthy lifestyle behaviors to reduce their risks for CVD. Healthcare providers may not promote awareness of CVD or consistently counsel female patients concerning lifestyle behavior modifications to reduce their risks for CVD. "The Evidence-Based Guidelines for the Prevention of Cardiovascular Disease in Women 2011 Update: A Guideline From the American Heart Association" provides a guide for healthcare providers to help women lower their risk for heart disease. By using a theoretical approach, nurses can facilitate implementation of these evidence-based guidelines to help women reduce their risks for CVD. Commonly used intrapersonal, interpersonal, and organizational- and community-level health behavior change theories that can be used to effectively promote CVD risk reduction in women will be discussed. The theoretical basis for changing CVD risk behaviors in women can be applied by using the PRECEDE-PROCEED Model to guide planning, implementing, and evaluating health behavior programs. The purpose of this article was to help nurses improve healthcare delivery by using the PRECEDE-PROCEED Model as a theoretical framework to guide CVD risk reduction efforts for women.     

Gender and knowledge about HIV,risky sexual behavior,and safer sex practices

The purpose of this study was to examine gender differences in knowledge about HIV, the reported incidence of risky sexual behavior, and comfort with safer sexual practices among young adults. The conceptual framework was social role theory, which argues for the influence of gender roles on beliefs and social behaviors. Participants were 141 female and 131 male college students who responded to questions regarding their knowledge of HIV, risk-taking behaviors with respect to HIV, and comfort with safer sexual behaviors. Overall, respondents had accurate knowledge about HIV. However, men reported engaging in significantly more risky behaviors than women. More men reported that intercourse without a condom occurred in unplanned, spontaneous situations, while under the influence of alcohol or drugs, or with a person not well known. More women reported that intercourse without a condom occurred in long-term relationships. Women were significantly more comfortable abstaining from sexual intercourse and asking partners about their sexual history while men were significantly more comfortable buying condoms. Both men and women reported comfort using condoms. Gender roles help to explain why men are willing to take more risks, and in what situations risk taking is apt to occur. ©1995 John Wiley & Sons, Inc.     

The influence of social support relationships on mammography screening in African-American women.

Evidence indicates that mammography screenings have increased in African-American women who are 50 years of age or older; however, they continue to experience later-stage discovery and poorer survival rates from breast cancer compared to White women. Although research has consistently found that social support relationships affects mammography screening in African-American women, little is known about the preventive health behaviors of individuals in these relationships that may be associated with mammography screening. This study examined that association and found that social support relationships, defined as blood-relatives and extended kinship networks, stressed personal responsibility and accountability for preventive health; therefore, supporting mammography screening. Of perhaps the greatest importance, the relationships emphasized positive strengths of African-American culture and invoked the necessity to confront prior negative experiences in health-care systems. These relationships also negated the fears or fatalistic beliefs about breast cancer that had been perpetuated by myths through informal communication and "deliberate silence" from significant others who had previously discouraged or de-emphasized the importance of mammography screening. Further research is needed to determine if the emphasis on cultural heritage was the only motivator that encouraged personal responsibility for mammography screening.     

Structural model for osteoporosis preventing behavior in postmenopausal women

BACKGROUND: Osteoporosis prevention behaviors (OPBs) can prevent and delay bone deterioration; dual-energy X-ray absorptiometry (DXA) scan can identify osteoporosis and provide personal osteoporosis risk information that may promote prevention behaviors. OBJECTIVES: This study was designed to estimate relationships between receiving personal knowledge of bone mineral density (gained through DXA scan), general knowledge of osteoporosis, health beliefs, and the two OPBs of calcium intake and weight-bearing exercise in healthy postmenopausal women 50 to 65 years. METHODS: In this longitudinal, randomized clinical trial (including covariates), receipt of personal DXA information was manipulated by random assignment to the experimental or control group. The remaining antecedent and outcome variable measures were collected by questionnaire at three time points (initial [T1; pre-DXA], 6 months [T2], 12 months [T3]) and by bone density assessment from 203 women over an 18-month period in 2001-2003. RESULTS: The experimental manipulation (DXA results) had a direct positive effect (beta = .23, p < .05) on calcium intake at T2, and indirectly at T3 through T2. Women in the experimental group who were informed they had osteopenia or osteoporosis had a greater T1-T2 change in daily calcium intake than those with normal bone density (beta = .23, p < .05). However, providing DXA results did not relate to change in exercise. Health beliefs and general osteoporosis knowledge predicted initial calcium and exercise levels; there was tentative evidence that susceptibility beliefs partially mediate between DXA results and change in calcium intake. DISCUSSION: Personal knowledge of DXA results was related significantly to increases in calcium intake in postmenopausal women, but not to exercise. Directions for further study are discussed.     

The role of exercise in the African-American woman with type 2 diabetes mellitus: application of the health belief model

PURPOSE: To determine whether aging African-American women with a diagnosis of type 2 diabetes mellitus who maintain a regular exercise regimen possess different health beliefs and benefit from greater glycemic control than those who do not exercise regularly. DATA SOURCES: A 32-item health belief model diabetes scale was administered to a convenience sample of 31 African-American women with type 2 diabetes. CONCLUSIONS: A group t-test identified statistically significant differences between "exercisers" and "non-exercisers" in perceived benefits and barriers to exercise and glycemic control. IMPLICATIONS FOR PRACTICE: Findings may be utilized in the development of diabetic educational programs and compliance-enhancing treatment interventions that focus on the barriers and benefits of diabetes self-management.